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April 13, 2011New England Journal of Medicine

Anticoagulant Options — Why the FDA Approved a Higher but Not a Lower Dose of Dabigatran

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Why the study?

Why did the FDA approve the 150-mg dose of dabigatran but not the 110-mg dose for reducing stroke and systemic embolism in patients with nonvalvular atrial fibrillation?

Population

Patients with nonvalvular atrial fibrillation

Comparison

Dabigatran 150-mg dose vs Dabigatran 110-mg dose

Design

Editorial

Key result

Dabigatran 150-mg was exclusively approved by the FDA to reduce stroke and systemic embolism in nonvalvular atrial fibrillation, despite the 110-mg dose also demonstrating effectiveness.

Authors

BBB. Nhi BeasleyEUEllis F. UngerRTRobert Temple

Discussion

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Overview

FDA limits dabigatran to 150 mg for nonvalvular AF; leaves open individualized 110-mg use in high-bleeding-risk patients.

Structured PICO

Why did the FDA approve the 150-mg dose of dabigatran but not the 110-mg dose for reducing stroke and systemic embolism in patients with nonvalvular atrial fibrillation?

P
Population
Patients with nonvalvular atrial fibrillation
I
Intervention
Dabigatran 150-mg dose
C
Comparator
Dabigatran 110-mg dose
O
Outcome
Stroke and systemic embolismhard clinical

The FDA approved only the 150-mg dose of dabigatran for stroke prevention in nonvalvular atrial fibrillation, determining that patients should receive the higher dose over the effective 110-mg alternative.

Cite This Study

Beasley et al. (2011) studied this question. Dabigatran 150-mg was exclusively approved by the FDA to reduce stroke and systemic embolism in nonvalvular atrial fibrillation, despite the 110-mg dose also demonstrating effectiveness.

synapsesocial.com/papers/6a6362e0d5a9273701096546https://doi.org/10.1056/nejmp1103050
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